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NPI Code Detail

MEDICARE: MS. RIANNE ISABEL CHAVEZ-HANSEN LMT, LMP

MEDICARE:  MS. RIANNE ISABEL CHAVEZ-HANSEN  LMT, LMP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1174400000XSpecialistMA48125FL
2174400000XSpecialistMA20039WA

General Provider Information

NPI Number : 1346364312
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. RIANNE ISABEL CHAVEZ-HANSEN LMT, LMP
Provider Business Mailing Address
First Line : 2101 NORTHSIDE DR UNIT 402
Second Line :
City : PANAMA CITY
State : FL
Zip : 32405-3687
Country : US
Telephone Number : 850-867-3795
Fax Number : 850-215-8398
Provider Business Practice Location Address
First Line : 2101 NORTHSIDE DR UNIT 402
Second Line :
City : PANAMA CITY
State : FL
Zip : 32405-3687
Country : US
Telephone Number : 850-867-3795
Fax Number : 850-215-8398
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/16/2007
Last Update Date : 07/08/2007

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Directions to “ MS. RIANNE ISABEL CHAVEZ-HANSEN LMT, LMP” Practice Location

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